Thoracoscopic Sympathicotomy vs Sympathectomy in Primary Hyperhidrosis

Background: Primary hyperhidrosis (P.H.H.) is characterized by excessive sweating in certain parts of body. It’s estimated prevalence is ۰%-۶.۱% in different populations. In Asian population its prevalence is around ۳%. In ۵۷% of cases, there is a positive family history. Objectives: To evaluate and compare the early and late satisfaction, outcomes and complications of thoracoscopic sympathectomy and sympathicotomy in the treatment of primary hyperhidrosis. Materials and Methods: From April ۲۰۰۷ to January ۲۰۱۱, we prospectively treated ۶۰ primary hyperhidrosis patients via thoracoscopic surgery. The first ۳۰ patients underwent sympathectomy and the next ۳۰ patients underwent sympathicotomy. We evaluated early and late satisfactions, outcomes and complications on the first visit (۵-۸days) following surgery and ۱۲ months after surgery, for all patients. Results: The mean operative time was ۶۶.۳ minutes in sympathicotomy group and ۱۱۰.۸ minutes in sympathectomy group (P < ۰.۰۰۱). There were no significant differences between the two groups in overall early and late satisfaction, gustatory sweating, pompholyx and post-operative pain. There was comparatively less early and late compensatory sweating (C.S.), and other adverse influences of C.S. in the sympathicotomy group. Conclusions: Because of shorter operative time, less C.S. and less adverse influence of C.S., sympathicotomy seems a better treatment for primary hyperhidrosis, compared with sympathectomy